(Circulation. 1997;96:2755-2757.)
© 1997 American Heart Association, Inc.
Articles |
Specialized Centers for Heart Failure Management
From the Heart Failure Program (W.T.A.) and Division of Cardiology (M.R.B.), University of Colorado Health Sciences Center (Denver).
Correspondence to Michael R. Bristow, MD, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Box B-139, Denver, CO 80262.
Key Words: Editorials • heart failure
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Introduction |
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The incidence of many forms of cardiovascular disease, such as acute myocardial infarction and stroke, has been on the decline over the past two decades. During this same time, the incidence of heart failure has markedly increased.1 2 In 1970, there were 250 000 new cases of heart failure diagnosed in the United States.1 By 1988, this number had grown to 400 000 cases,1 and in 1992, nearly 700 000 new cases of heart failure were identified.2 This increasing incidence of heart failure in the United States has resulted in a current prevalence of heart failure of nearly 5 million cases, or
1.5% of the US
population.2 Moreover, heart failure is a disease syndrome
associated with aging; that is, both the incidence and prevalence of
heart failure increase in the elderly population. For example, if one
examines the prevalence of heart failure in those more than 75 years
old, nearly 10% of this elderly population exhibits the clinical
syndrome of chronic heart failure.3
Given this, heart failure is now the most common diagnosis-related
group (DRG) discharge diagnosis for those aged more than 65 years old,
and it is the fourth leading cause of hospitalization in US
adults.4 This has resulted in a substantial economic
burden. Estimates of the total direct costs of heart failure treatment
in the United States range from $10 billion to nearly $40
billion.2 5 6 Data recently summarized by Konstam et
al5 for the Agency for Health Care Policy and Research
indicate the following annual expenditure for heart failure
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